The consequences of COVID-19 outbreak on outpatient rehabilitation services: a single-center experience in Slovenia.

ABSTRACT

BACKGROUND: The COVID-19 pandemic was the reason for closing down all non-urgent outpatient services in hospitals treating COVID-19 patients. The lockdown and reorganization of medical units also altered the accessibility to outpatient rehabilitation services. AIM: The focus of interest in our report lies in the evaluation of the outpatient rehabilitation treatment accessibility at our center in the time of the COVID-19 pandemic. DESIGN: Cross-sectional observational study. SETTING: Outpatients Rehabilitation Unit at University Medical Centre Maribor (UMC Maribor), Slovenia. POPULATION Patients with diverse pathologies referred to outpatient rehabilitation. METHODS: The data were gathered retrospectively at the Institute of Physical and Rehabilitation Medicine (IPRM) at the UMC Maribor. The search included all the patients treated at IPRM in the pre-COVID and COVID period from March 16 to August 31 in 2019 and 2020. The data for the period including the lockdown (March 16 to August 31, 2020) and the period after the lockdown (June 1 to August 31, 2020) was analyzed and compared to the same timeframes in 2019. We were interested in the magnitude of decline in the total number of patients, the number of the first and follow-up visits, the number of sessions and in the profile and pathologies of patients comparing pre-COVID and COVID period. The χ2 and Fisher's Exact test were used in the analysis. RESULTS: With the lockdown period included there was a 44% decline in the total number of patients, a 71.1% decline in the number of sessions, a 42% decline of the first visits and a 60.9% decline of follow-up visits. When comparing the pre-COVID and COVID period after the lockdown, a 28.5% decline in the number of patients treated in 2020 compared to 2019 was observed. By analyzing the number of sessions in the pre-COVID and COVID period after the lockdown there was a 46.6% decline. No statistically significant difference was found in the age groups between the two periods (X2=9.466; P=0.05). The difference for the first and follow-up visits in 2019 and 2020 proved to be statistically significant (P<0.001), as well as the difference in percentage of patients in the acute and chronic group (P=0.037). CONCLUSIONS: Our findings showed how COVID-19 outbreak hindered the accessibility to outpatient rehabilitation service. Not only has the number of patients substantially reduced in the year 2020 compared to 2019, but also the number of sessions and number of first and follow-up visits declined. The demographic structure of the patients remained the same. CLINICAL REHABILITATION IMPACT This study adds evidence at the level of health services about lower standard of care in the physical and rehabilitation medicine field for patients experiencing disabling conditions in the time of COVID-19.